Abstract
Background: Nutrition therapy is essential in critically ill adults. Little is known about appropriate nutrition therapy in patients with severe coronavirus disease 2019 (COVID-19) infection.
Methods: This was a retrospective, observational study in adult patients with confirmed COVID-19 infection receiving mechanical ventilation. Data regarding patient demographics and nutrition therapy were collected. Patients that received enteral nutrition within 24 hours of starting mechanical ventilation were compared with patients starting enteral nutrition later. The primary outcome was inpatient length of stay. Propensity score matching was conducted to control for baseline differences in patient groups.
Results: One hundred fifty-five patients were included in final analysis. Patients who received enteral nutrition within 24 hours received a significantly greater daily amount of calories (17.5 vs 15.2 kcal/kg, P = .015) and protein (1.04 vs 0.85 g/kg, P = .003). There was no difference in length of stay (18.5 vs 23.5 days, P = .37). The propensity score analysis included 100 patients. Following propensity scoring, significant differences in daily calorie (17.7 [4.6] vs 15.1 [5.1] kcal/kg/d, P = .009) and protein (1.03 [0.35] vs 0.86 [0.38] g/kg/d, P = .014) provision remained. No differences in length of stay or other outcomes were noted in the propensity score analysis.
Conclusion: Initiation of enteral nutrition within 24 hours was not associated with improved outcomes in mechanically ventilated adults with COVID-19. No harm was detected either. Future research should seek to clarify optimal timing of enteral nutrition initiation in patients with COVID-19 who require mechanical ventilation.
Keywords: COVID-19; SARS-CoV-2; critical care; enteral nutrition; length of stay; mechanical ventilation.
【저자키워드】 COVID-19, SARS-CoV-2, Critical care, mechanical ventilation, enteral nutrition, Length of stay, 【초록키워드】 coronavirus disease, Coronavirus disease 2019, therapy, Critical care, mechanical ventilation, Infection, outcome, observational study, Protein, Adults, Critically ill, COVID-19 infection, Research, Patient, enteral nutrition, Critical, patients, Propensity score, retrospective, Analysis, propensity score matching, demographics, final analysis, 24 hours, Nutrition therapy, Primary outcome, significant difference, Other outcomes, severe coronavirus disease, Adult patients, no difference, patient groups, no differences, Confirmed COVID-19 infection, Final, mechanically ventilated, propensity score analysis, Future, calorie, calories, greater, collected, significantly, remained, conducted, receiving, 24 hour, baseline, calory, Initiation, patients with COVID-19, with COVID-19, 【제목키워드】 nutrition, Enteral,